Prosthetic Joint Infections
PATHOGENS
- Staphylococci account for >50% of total prosthetic joint infections (PJI). Gram-negatives may account for 15%. Approximately 20% may be polymicrobial.
- Culture-negative infections represent ~7-11% of infections; some may be due to prior abx therapy.
- Bacterial:
- Staphylococcus (coagulase-negative)
- Staphylococcus aureus
- Viridans streptococci
- Cutibacterium acnes (especially shoulder implant infections, formerly Propionibacterium)
- Enterococcal species
- Gram-negative enteric bacteria
- Pseudomonas aeruginosa
- Anaerobes
- Brucella spp (rare)
- Mycobacterial:
- Non-tubercular mycobacteria (rare)
- M. tuberculosis (very rare)
- Fungal:
- Candida species
- Typical pathogens by the time of onset following prosthesis placement:
- Early infection (0-3 months post-op): predominantly S. aureus, β-hemolytic streptococci, Gram-negative bacilli, polymicrobial infection, anaerobic
- Delayed (3 mos-2 yrs): usual pathogens include coagulase-negative Staphylococci,S. aureus,C. acnes, Enterococcus spp.
- Late (>2 yrs): S. aureus, coagulase-negative Staphylococci, viridans Streptococci, Enterococci, C. acnes
- Less common: Gram-negatives
There's more to see -- the rest of this topic is available only to subscribers.
Last updated: August 8, 2022
Citation
Auwaerter, Paul G, and Sara Keller. "Prosthetic Joint Infections." Johns Hopkins ABX Guide, The Johns Hopkins University, 2022. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540256/all/Prosthetic_Joint_Infections.
Auwaerter PG, Keller S. Prosthetic Joint Infections. Johns Hopkins ABX Guide. The Johns Hopkins University; 2022. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540256/all/Prosthetic_Joint_Infections. Accessed December 4, 2024.
Auwaerter, P. G., & Keller, S. (2022). Prosthetic Joint Infections. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540256/all/Prosthetic_Joint_Infections
Auwaerter PG, Keller S. Prosthetic Joint Infections [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2022. [cited 2024 December 04]. Available from: https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540256/all/Prosthetic_Joint_Infections.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Prosthetic Joint Infections
ID - 540256
A1 - Auwaerter,Paul,M.D.
AU - Keller,Sara,M.D.
Y1 - 2022/08/08/
BT - Johns Hopkins ABX Guide
UR - https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540256/all/Prosthetic_Joint_Infections
PB - The Johns Hopkins University
DB - Pediatrics Central
DP - Unbound Medicine
ER -